Jeremy Wallick, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

25484 Issued in MD

Practice address

801 N Broadway
Baltimore, MD 21205-1424

Phone

(443) 923-9468

NPI assigned

Jun 24, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• William J Pogoda MD PA

  • Specialist
  • Hunt Valley, MD
  • NPI 1619098696
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1891177960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051424",
            "telephone_number": "443-923-9468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051424",
            "telephone_number": "443-923-9468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Schilling Rd Ste Ll3",
            "address_purpose": "LOCATION",
            "city": "Hunt Valley",
            "state": "MD",
            "postal_code": "21031",
            "country_code": "US",
            "telephone_number": "410-229-9800",
            "fax_number": "410-229-9801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10753 Falls Rd",
            "address_2": "Suite 235",
            "address_purpose": "LOCATION",
            "city": "Lutherville",
            "state": "MD",
            "postal_code": "210934535",
            "country_code": "US",
            "telephone_number": "410-583-2665",
            "fax_number": "410-847-3838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLICK",
        "first_name": "JEREMY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jana Wallen
• Matthew H Wallengren, DDS, PA
• Ami C. Waller
• Jessica Price D'Argenio Waller, M.S., C.N.S., L.D.N.
• Sheila Waller, CRNP
• Jo Lynne Wallin-Wais, PHARM.D., BCPS
• Janice Wallop, N.P.
• Rachel Wallwork, MD
• Joseph Walpole, MD, PHD
• Kenneth Walrond, PT, DPT, CSCS

• Physical Therapist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.